<include file="Xeninc:header" title="忘记密码"/>

    <div class="container">

		<div class="pdm-signin">
			<h3>忘记密码</h3>
			<form role="form" action="" method="post">
			  <div class="form-group">
				<label for="email">Email</label>
				<input type="email" name="email" class="form-control" id="email" placeholder="">
			  </div>
			  <div class="form-group">
				<label for="verification_code"></label>
				<img id="captcha" rel="{:pdm_ux('captcha')}" src="{:pdm_ux('captcha')}"/>
			  </div>
			  <div class="form-group">
				<label for="verification_code">请输入上图中的拼音</label>
				
				<input type="verification_code" class="form-control" id="verification_code" name="verification_code" placeholder="验证码">
			  </div>
			  <button type="submit" class="btn btn-primary">提交申请</button>
			</form>
		</div>  
	  
	
    </div>
<include file="Xeninc:footer"/>